Paul Boyar. The. scholarship

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1 The Paul Boyar scholarship It is not what you do but how you do what you do that defines you as a person. Paul dedicated his life and love to the long term care profession. He served as Administrator of Marquis Care at Plaza Regency for 10 years and a past President of the Nevada Healthcare Association. He chose to set high standards of excellence and relentlessly reinforced quality. Most importantly Paul touched the lives of people every day with his deep compassion. He recruited and retained excellent employees and encouraged staff to continue to grow and become leaders. Each person he encountered was treated with dignity and respect. Paul would do anything for a friend, including his staff. If you would have met Paul, you would have found out quickly that he was intensely proud of his facility and staff, his wife Dhyani, and his son Jonathon. Even though Paul will be greatly missed, his legacy will continue to live on. FOR AN APPLICATION AND COMPLETE DETAILS, VISIT

2 In honor of Paul Boyar of Marquis Companies Criteria Information Candidates must meet at least one of the following criteria: Currently working in any long term care profession (such as nursing, health services, activities/life enrichment, dietary/dining services, social work, physical or occupational therapy, and residential or assisted living health care or facility management) with a desire to gain additional certification, licensure, or other degree through an accredited educational program in a field related to long term care. Enrolled or about to be enrolled in an educational program related to healthcare and seeking to work in long term care. Please note: Proof of acceptance into an accredited program should be submitted with scholarship application. Proof of enrollment will be required for the release of scholarship funds. Recipients must be of Junior or Senior standing. Candidates not currently enrolled in or accepted into an accredited program may be awarded, but scholarship funds will not be released until proof of enrollment is submitted to the Vital Live Foundation. Scholarship funds may be used for payment of tuition. Two Healthcare Administration Scholarships will be awarded in the amount of $2,500. One scholarship will be awarded to a student seeking a Bachelor of Science in Health Care Administration and Policy with the intent of a career in Long Term Care. One scholarship will be awarded to a student seeking a Masters of Health Care Administration with the intent of a career in Long Term Care. Scholarship funds may be awarded for a multi-year period contingent upon the candidate s yearly submission of proof of enrollment and competency (transcript) in a relevant degree program, and reapplication. Scholarships will be awarded in the Spring of each academic year, on or around January 31. Applicants must supply all information requested in this application. Incomplete applications WILL NOT be considered. Please submit completed application by January 1: Vital Life Foundation 4560 SE International Way, Suite 100 Milwaukie, OR Tel: Fax: pg 2

3 Please fill in the required information on these sheets by writing clearly, or you may reproduce the forms on a computer using the same format. General Information: First Name: Last Name: Mailing Address: City: State: Zip: Phone: ( ) Preferred Way to Contact You: Are you currently working in LTC? Yes: How long have you worked in LTC? Years Months No: Describe why you are interested in a LTC career: What is your long term care professional goal or the position you are seeking? Have you previously received a Paul Boyar Scholarship? Yes: Date(s) received: No Please indicate how you will use your scholarship funds, if awarded (ex. Tuition, fees, supplies, and/or books): Please indicate what other funding you are receiving for your education: pg 3

4 Current Education: Please check one statement below that best describes your current academic situation and include the requested info: I am currently enrolled in an accredited academic program: Institution name/program title and location: (Submit proof of enrollment with application) Start Date: Completion Date: Cost of Program: Area of Study: Degree Anticipated: Current GPA: I have applied and been accepted into a program, but my enrollment is dependent on funding: Institution name/program title and location: (Submit proof of acceptance with application. Proof of enrollment will be required) Start Date: Completion Date: Cost of Program: Area of Study: I have applied to a program and if I am accepted, and awarded this scholarship, I intend to enroll. Institution name/program title and location: Start Date: Completion Date: Cost of Program: Area of Study: Degree Anticipated: None of the above. Please explain: Will the academic credits you are currently earning, or plan to earn, transfer to a community college, four year college, and/or a post graduate program? Yes No I Don t Know pg 4

5 Previous Education: (check all that apply and include requested info) High School (Name/Location): Graduation Date: Community College (Name): Dates of Attendance (or anticipated completion date): Area of Study: Degree Obtained (or anticipated): College/University (Name): Dates of Attendance (or anticipated completion date): Area of Study: Degree Obtained (or anticipated): Post Graduate Study (Name): Dates of Attendance (or anticipated completion date): Area of Study: Degree Obtained (or anticipated): Other Educational Programs (Name): Dates of Attendance (or anticipated completion date): Area of Study: Degree Obtained (or anticipated): Current Work Experience: Position: Start Date: / / Place of Employment: Number of hours worked per week: Work address: City: State: Zip: Phone: (W): ( ) Fax: (W): ( ) (W): Supervisor Name: Supervisor *If not currently working in long term care or a related field, please include a statement of interest in working in LTC in your personal essay. pg 5

6 Previous Work Experience: Previous Employer: Position: Employment Dates: to Supervisor Name: Supervisor Previous Employer: Position: Employment Dates: to Supervisor Name: Supervisor Previous Employer: Position: Employment Dates: to Supervisor Name: Supervisor Other Work or Volunteer Experiences: Personal Essay: Please type a brief essay (1-2 pages, double spaced) on separate paper and attach to your application Print your full name on each page of the essay submission. In the essay, please introduce yourself; describe why you enjoy working in the long term care profession, and why you are good at working with seniors. Speak to your commitment to the profession, your passion for the work, your ideas of what the future of long term care will be like, and your abilities (traits/skills and characteristics) that make you the ideal candidate for this scholarship. Use specific anecdotes, life experiences and stories to illustrate your points. Indicate why the education program you are pursuing will contribute to your success in the long term care profession. Letters of Recommendation: Three letters of recommendation are required from a current supervisor/manager, academic professor/ advisor, or other person knowledgeable about your qualifications. Additional letters of recommendation from colleagues, academic instructors, etc. may be submitted as well. Letters must be mail to VLF by January 1. Letters of recommendation should speak to the candidates qualities, skills and performance in their current position and personality traits, values and characteristics that would contribute to their success in the long term care profession they have identified as their goal. Letters must address the candidate s demonstrated interest and commitment to the long term care profession. Recommendation letters should also explain why the candidate would benefit from additional education/training and why the long term care profession would benefit from their continued service. Letters from supervisors or managers of communities should be submitted on the official stationery of the facility, and must include the name of the reference both printed AND signed, their title, company, and the date the letter was written. Additional letters may be submitted on personal stationery, must reference the relationship with the candidate, and colleagues should provide their current employment information including title and contact information. References must include phone numbers and addresses. pg 6

7 Signed Commitment of Intention Please initial the statements below and sign your name at the bottom. Please submit with your scholarship application. I understand that by submitting this application I am applying for the Healthcare Administration Scholarship and to the best of my knowledge I meet the criteria for this Scholarship described on page one of this application. I agree that all information contained in this application is true and factual. If I receive the Healthcare Administration Scholarship, I commit to completing the education program for which the scholarship was awarded. I agree to work in the field of long term care for at least three years after the completion of the academic program for which the scholarship is awarded, and to provide VLF documentation of this fact. I agree to submit documentation to VLF upon completion of the current academic program for which the scholarship is awarded and to submit a brief summary of my experiences, including how my scholarship was used. I agree to allow the VLF to promote my award and use my image and the information contained in this application for that purpose. If I am unable to fulfill these agreements for any reason, I agree to immediately repay VLF the full amount of my scholarship award. I agree to complete an internship in long term care with a project focus of improving the organization. Print Name: Signature: Date: pg 7

8 Submission checklist Please use this checklist to make sure you include the required information. Eligible submissions must include ALL of the following: Completed pages 2-4 of this application requesting basic education and work experience Personal essay submitted on a separate sheet of paper Appropriate Academic Records Enrolled Students: most recent transcript with grades and program completion date New Students: A copy of an acceptance letter from a school or accredited program Prospective Students: A dated copy of your application or other documentation of your plan to enroll. (funds will only be sent upon submission of proof of enrollment in an academic program). Letter of recommendation completed by a current supervisor/manager, academic professor/advisor, or other person knowledgeable about your qualifications Additional letters of recommendation (optional) Signed commitment of intention (page 7) with your agreement to work in the field of long term care for at least three years after receipt of licensure, degree, or certification associated with the education program funded by the scholarship and to provide follow up documentation of this fact and a summary of how the funds were used. Completed application paper clipped together; not stapled Application mailed to VLF by January 1 Applications not meeting the above criteria will not be considered. Vital Life Foundation 4560 SE International Way, Suite 100 Milwaukie, OR Tel: Fax: pg 8

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